Healthcare Provider Details

I. General information

NPI: 1780779124
Provider Name (Legal Business Name): LUKAS PETER ZEBALA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 GROSS POINT RD STE 1200
SKOKIE IL
60076-1214
US

IV. Provider business mailing address

9600 GROSS POINT RD STE 1200
SKOKIE IL
60076-1214
US

V. Phone/Fax

Practice location:
  • Phone: 847-866-7846
  • Fax: 224-251-5150
Mailing address:
  • Phone: 847-866-7846
  • Fax: 224-251-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number036136276
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: